Breast Cancer Rates Jump Worldwide, Study Finds

The number of new cases of breast cancer has jumped dramatically worldwide, from about 640,000 in 1980 to more than 1.6 million in 2010, University of Washington researchers report.
Over the same period, the number of cases of cervical cancer has crept up much more slowly and deaths from that cancer have declined, although in 2010 it still killed 200,000 women around the world. In 2010, 51 percent of new cases of breast cancer and 76 percent of the 454,000 cases of cervical cancer were in developing countries, the researchers noted.
"The world used to think of breast cancer as a problem that only high-income countries had and cervical cancer as a problem mainly for developing countries," said coauthor Dr. Rafael Lozano, a professor of global health at the university's Institute for Health Metrics and Evaluation.
"What we have found is that while countries such as the United States and United Kingdom have been able to greatly lower the risk of women dying from breast cancer, through better screening and treatment, countries with fewer resources are seeing their risks go up," he said.
The world rightly recognizes that no woman should die because of complications related to pregnancy and childbirth, Lozano said. "Now that we can clearly see the trends in breast and cervical cancer, they need to become a central part of the discussion when priorities are being set for women's health programs," he said.
The report was published in the Sept. 15 online edition of The Lancet.
For the study, Lozano and colleagues collected data from more than 300 cancer registries and cause-of-death offices in 187 countries.
During the 30 years covered by the study, breast cancer cases have increased in all parts of the world by 3.1 percent a year, the researchers found.

In addition, among women aged 15 to 49 there were twice as many cases of breast cancer in developing countries than in developed countries, they note. Deaths from breast cancer were also higher in developing countries compared with developed countries.
However, around the world the increase in deaths from breast cancer has been slower than the increases in cases. This may be due possibly to early detection and treatment advances in developed countries, the researchers say.
"It is clear from the data that since the late 1980s, women who develop breast cancer have had a better chance of surviving because early screening is working and treatment is working," Lozano said.
In 1980, one out of every 32 women in the United States risked dying from breast cancer. By 2010, one out of every 46 women had that risk, he added.
When one looks at countries where screening and treatment are not as widely available, the trend is in the opposite direction, Lozano said.
"In Zimbabwe, for example, the risk has gone from one in 64 women dying to one in 35. Not only is the threat of breast cancer and cervical cancer shifting more heavily toward developing countries, it also is shifting to women of reproductive age," he said.
It used to be that these cancers were predominately a problem for women over 50, but more and more women in sub-Saharan Africa, the Middle East and South Asia are being hit by these cancers between the ages of 15 and 49, Lozano said. "In Bangladesh, more than 60 percent of women dying from breast cancer are under age 50," he added.
Since 1980, new cases and deaths from cervical cancer have increased mainly in south and east Asia, Latin America, and Africa, but have dropped substantially in high-income countries, particularly where widespread screening is available, Lozano's group found.
"Our concern there is that this is a disease that is almost entirely preventable through safe sex practices and early detection, yet it continues to kill" hundreds of thousands of women every year, Lozano said.
Ahmedin Jemal, vice president for surveillance research at the American Cancer Society, said the increase in breast cancer diagnosis is partly to increased awareness.
But most importantly, he said, the risk factors for breast cancer include reproductive factors such as late child bearing and late menopause. These factors increase with economic development [and so] increased in the developing world -- not as much as in the developed world. But, that's the driving factor," he said.

In addition, obesity is a risk factor for breast cancer and it has been increasing around the world, Jemal said.
To reduce the incidence of breast cancer, Jemal says, more awareness of early detection and access to care is needed. Also, women should be encouraged to reduce the known risk factors for the disease, he said, such as obesity.
As far as cervical cancer is concerned, the increase in developing areas is due to lack of access to screening with Pap tests, he said. With the development of the HPV vaccine, Jemal said he hopes to see the rate of cervical cancer decline, especially since drug makers are making the vaccine available at a low price to developing areas.

Health Tip: Coping With a Pet Allergy

Just because you or your child has a pet allergy doesn't mean Fido or Fifi has to move out, the American Academy of Allergy Asthma and Immunology says.

The academy offers these suggestions to better cope with a pet allergy:

• Do your best to avoid kissing and hugging pets.
• Keep your bedroom and upholstered furniture off-limits to pets.
• Give your pets a weekly bath, and ask a non-allergic friend or family member to regularly brush them outdoors.
• Ask your veterinarian about a well-balanced diet for pets, which can minimize dander.
• Vacuum with a micro-filter or double bag, and use a HEPA air cleaner at home.
• Minimize carpeting and rugs in your home, as they attract dander.

Health Tip: Is Your Child Ready for a Tricycle?

A tricycle is good exercise for a growing toddler, and can foster a sense of independence. But it can also injure the child if he or she is too young to ride.

The American Academy of Pediatrics mentions these guidelines for getting your toddler on a tricycle:

• Make sure the child is physically capable of riding a tricycle. Typically, the child should be about 3 years old.
• Choose a tricycle with large wheels that sits low to the ground. This type is less likely to fall over.
• Make sure your child wears a properly fitting helmet each time he or she rides.
• Let your child ride the tricycle only in a safe area -- never around cars, in driveways or by a swimming pool.

Certain 'Senior Moments' May Signal Mental Decline

Those "senior moments" that plague so many aging Baby Boomers may or may not be a sign of more serious problems down the line.

New research finds that losing your train of thought or forgetting where you placed your keys may be a fairly benign -- albeit annoying -- sign of age. But having trouble remembering what happened a few minutes ago, or getting lost in familiar places, may be more serious.

The information, published in the September issue of the Journal of the American Geriatrics Society, should help primary care physicians sort out the mundane from the more troublesome when they see elderly patients.

"They should be asking their patients if they have any complaints [about memory or thinking skills]," said study lead author Rebecca Amariglio, a neuropsychologist with Brigham and Women's Hospital and Harvard Medical School in Boston. "When you're getting old, it's common to ignore these complaints."

President Obama's Affordable Care Act includes a provision for screening for these types of problems, called cognitive problems, at a person's annual physical exam.

So researchers are trying to find simple ways to sort out which patients can go home (relatively) reassured, and which might need further testing for Alzheimer's disease or another form of dementia.

For this study, researchers quizzed almost 17,000 women, average age about 74, over the telephone about their own recollections of memory lapses. The investigators then correlated this data with how the women scored on standard cognitive tests, including delayed recall of sets of words and numbers, also administered over the telephone.

The researchers used a set of questions -- seven in all -- which asked the participants if they had recently experienced a change in their ability to remember things, whether they had trouble remembering a short list of items (such as a shopping list), whether they had trouble remembering recent events, and whether they had trouble remembering things from one second to the next.

The women were also asked whether they had difficulty following spoken or written instructions, whether they had more trouble than usual following a group conversation or TV program due to memory problems, or whether they had trouble finding their way around familiar streets.

"Getting lost," in particular, was highly associated with cognitive impairment. Women who reported they had gotten lost in familiar neighborhoods tended to score significantly lower on cognitive tests similar to those used to detect signs of Alzheimer's. Having trouble keeping up with a group conversation and difficulty following instructions were also strongly associated -- though not as highly -- with cognitive impairment.

On the other hand, forgetting things from one moment to the next was not associated with any decline in measure of cognitive function.

But the more complaints a woman had, the more likely she was to score poorly on the test administered by investigators. Each additional complaint was associated with a 20 percent increase in cognitive impairment. (The complaint of forgetting one moment to the next had a score of zero since it was not associated with impairment.)

The authors noted that the participants were all women and mostly white, however, which means that the findings may not be generalizable to other populations.

Another expert pointed out other limitations of the study.

The "senior moments" reported by the study participants were only related to how well they did on the telephone tests, not to whether or not the person had actual dementia, according to Mary Sano, professor of psychiatry and director of the Alzheimer's Disease Research Center at Mount Sinai School of Medicine in New York City.

"This may overstate the problem, which also is not a good thing," she said, adding that the study does not trace the source of any problems it uncovered.

"The next step going forward would be to develop specific questions to ask [and] to see if this relates to dementia," Amariglio said.

For now, simple questions don't portend "what the future holds," she added. But answers may indicate that follow-up is warranted.

"It's one little extra red flag that can maybe direct decisions," Amariglio said.

Lung Cancer Rates Begin to Decline for U.S. Women

The rate of new lung cancer cases among American women is finally beginning to decline, much as it has for men in for years, a new U.S. government report shows.

New cases of lung malignancies fell by 2.2 percent per year on average for women between 2006 and 2008, after rising an average of 0.5 percent between 1999 and 2006, according to the U.S. Centers for Disease Control and Prevention.

Men's lung cancer incidence continued its long, slow decline, the agency added, but the pace of that decline has sped up in recent years. New cases fell by an average of 1.4 percent per year between 1999 and 2006 but that accelerated to a drop of nearly 3 percent per year by 2006-2008, the CDC said.

Between 1999 and 2008, declines in new lung cancer cases were seen among men in 35 states, while the rate remained stable in nine states. For women, six states -- California, Florida, Nevada, Oregon, Texas and Washington -- saw declines in lung cancer incidence during the same time period. Lung cancer rates for women remained stable in 24 states and they increased slightly in 14 states, the CDC team found.

While the trends are heartening, more needs to be done to stop the nation's number one cancer killer, said CDC Director Dr. Thomas R. Freiden. "Although lung cancer among men and women has decreased over the past few years, too many people continue to get sick and die from lung cancers, most of which are caused by smoking," he said in an agency news release. "The more we invest in proven tobacco control efforts, the fewer people will die from lung cancer."

Declines in lung cancer rates seemed closely tied to the fading popularity of lighting up. The report's authors note that lung cancers fell fastest in the West, where smoking among both men and women is lowest.

According to the reports' authors, certain moves by states seemed to result in steeper declines in lung cancer cases. These included boosting tobacco prices, enforcing 100 percent smoke-free policies and making quit-smoking resources accessible for people motivated to quit.

The findings are published in the Sept. 16 issue of the CDC's journal Morbidity and Mortality Weekly Report.